A1C-Chronicles:

October 2025

Empowering Your Diabetes Journey,  Together 💙

 👋 ,

Welcome back to A1C-Chronicles!

To our Diabetes Express Family,

Thank you for choosing us to be a part of your diabetes journey! Sorry we missed you last month but we hope to make it up to you with some interesting items to cover in this newsletter. Our DE Investigates topic comes directly from a reader inquiry about sleep and blood sugar. As always...

Its all a part of Empowering Your Diabetes Journey, Together!

A1C- Chronicles brought to you by:

Thank you for joining us at Connected In Motion's Ontario Slipstream!

"Although it’s hard to put into words, being surrounded for an entire weekend with other T1’s that totally “get it” from every finger prick, every high, every low, every carb count, every step i take in this T1 journey is beyond priceless!"

A Heartfelt Thank You 

Hello everyone,

I want to extend my deepest gratitude to each and every one of you for the dedication and heart you poured into making this campaign such a success. When I first dreamed of cycling across Canada to bring communities together, it felt like just that—a dream. But this journey became reality because of the collaboration, support, and teamwork from all of you.

Over the three months I spent on the road, I learned countless lessons. The one that stands out most is this: the impact we can make when we work together is truly extraordinary. With a common vision and united effort, anything is possible.

This initiative will leave a lasting mark on the lives of countless people, well beyond the three months of the ride itself. The funds raised will directly support hundreds of families across Canada, and I am so proud to have been part of this team. Your support is something I will carry with me for the rest of my life.

My sincerest thanks,

Simeon King

🔽 Another T1D Hero Raising Support For I Challenge Diabetes 🔽

Josie's Tips: Back to School with Confidence!

Hi everyone, Josie here!

I hope the return to the the school year has been enjoyable and safe for parents and students. Whether it's your first time sending a child with insulin needs to school, or you're a seasoned pro, the new school year requires some preparation. A successful and safe school year is built on a strong foundation of communication, planning, and readiness. Let's make this year the smoothest one yet!

Your Back-to-School Checklist 🎒

The key to a stress-free start is a comprehensive plan. Here's what you need to do:

Develop an Individual Care Plan (ICP) or DMMP: This is the most crucial document. An ICP, also known as a Diabetes Medical Management Plan (DMMP), outlines everything your child needs for safe diabetes management at school. It should include:

• Your child's target blood sugar range.
• Instructions for checking blood sugar and administering insulin (including doses and timing).
• Specific symptoms of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) for your child.
• Step-by-step instructions for treating both highs and lows.
• Emergency contacts.
• Information on your child's diabetes technology (pumps, CGMs, etc.).

Organize Your Supplies: Prepare a "low box" or emergency kit for the classroom and school office. This should be easily accessible to your child and school staff.  Include essentials like:

• Fast-acting carbohydrates (glucose tablets, juice boxes).
• Glucagon.
• Ketone strips.
• Extra blood sugar meter, lancets, and test strips.
• Backup pump supplies (if applicable).
• A printed copy of the ICP.
• Make sure your child's backpack is also fully stocked with their personal daily supplies.

Establish a Team: Your child's school is now a part of their care team! Schedule a meeting with the principal, classroom teacher, school nurse, and any other staff who will be with your child (e.g., gym teacher, bus driver). Review the ICP with them and explain your child's specific needs. Discuss who is trained and available to help with insulin administration and emergency care.

Communicate About Technology: Many students use a CGM and/or insulin pump, and these devices often require a smartphone or receiver. Ensure the school understands that these devices are medical equipment and that your child must have them at all times. Talk about how to handle any alarms or alerts.

Empower Your Child: Depending on your child's age and maturity, empower them to take on more responsibility for their diabetes care. This could be as simple as checking their own blood sugar or as complex as giving their own insulin. This independence builds confidence and prepares them for the future.

By taking these steps, you're not just preparing for the school year; you're creating an environment where your child can thrive, learn, and feel safe and supported.

Until next time...

🔽 How Educators Can Support Students with T1D This video from Breakthrough T1D offers a helpful guide for educators and support staff on how to support students with diabetes at school.

Thanksgiving Air Fryer Apple Fritters

Prep time: 20 minutes; Cook time: 12-15 minutes per batch; Yields: 12-14 fritters

Ingredients:

For the Fritters:

• 1 large egg
• 1/2 cup unsweetened almond milk (or any low-fat milk)
• 1/2 teaspoon vanilla extract
• 1/2 cup whole wheat pastry flour (or regular whole wheat flour for denser texture)
• 1/4 cup almond flour (or more whole wheat flour if you prefer)
• 1/4 cup powdered erythritol blend (or other sugar-free granular sweetener, to taste)
• 1 scoop (approx. 2 tbsp) unflavored collagen or vanilla protein powder (optional, but recommended for protein boost)
• 2 teaspoons baking powder
• 1 teaspoon ground cinnamon
• 1/4 teaspoon ground nutmeg
• Pinch of salt
• 2 medium apples (like Granny Smith or Honeycrisp), peeled, cored, and finely diced (about 1.5 cups)
• Cooking spray or a little oil for the air fryer

For the Sugar-Free Glaze:

• 1/2 cup powdered erythritol (pure, not a blend, for best texture)
• 1-2 tablespoons unsweetened almond milk or sugar-free apple cider
• 1/4 teaspoon vanilla extract

Directions:

1. Prepare Apples: Peel, core, and finely dice the apples. Set aside.
2. Whisk Wet Ingredients: In a medium bowl, whisk together the egg, almond milk, and vanilla extract until well combined.
3. Combine Dry Ingredients: In a large bowl, whisk together the whole wheat pastry flour, almond flour, powdered erythritol, optional protein powder, baking powder, cinnamon, nutmeg, and salt. Ensure there are no lumps.
4. Combine Wet and Dry: Pour the wet ingredients into the dry ingredients. Stir with a spatula until just combined. Be careful not to overmix; a few lumps are fine. The batter will be thick.
5. Fold in Apples: Gently fold in the diced apples until evenly distributed throughout the batter.
6. Preheat Air Fryer: Preheat your air fryer to 350°F (175°C).
7. Air Fry Fritters: Lightly spray the air fryer basket with cooking spray. Drop spoonfuls (about 1.5-2 tablespoons each) of the batter into the air fryer basket, leaving space between them for air circulation. Do not overcrowd.
8. Air fry for 12-15 minutes, flipping halfway through, until the fritters are golden brown and cooked through. Cooking time may vary depending on your air fryer model and fritter size.
9. Remove fritters and place them on a wire rack. Repeat with remaining batter
10. Make the Glaze: While the fritters cool slightly, whisk together the powdered erythritol, almond milk (or sugar-free cider), and vanilla extract in a small bowl until smooth. Start with 1 tablespoon of liquid and add more, a teaspoon at a time, until you reach your desired consistency.
11. Glaze and Serve: Drizzle the sugar-free glaze over the warm (but not hot) fritters. Let the glaze set for a few minutes before serving. Store any leftovers in an airtight container in the refrigerator.

Sleep, Stress, and CGM Data—The Unseen Variables

The Hormonal Highway

The link between stress, poor sleep, and high blood sugar is mediated by the body's primary stress response system, the Hypothalamic-Pituitary-Adrenal (HPA) axis, and the resulting surge of hormones.

1. The Stress Hormone (Cortisol): When you experience physical or psychological stress, your body activates the HPA axis, leading to the release of cortisol and catecholamines (like adrenaline). These are counter-regulatory hormones that oppose insulin's actions. Research shows that:
   • Cortisol induces hepatic gluconeogenesis (the liver producing and releasing stored glucose) and inhibits the peripheral uptake of glucose by muscle and fat cells. This results in an acute rise in blood sugar that can be resistant to typical insulin correction doses.
   • Chronic stress leads to sustained high levels of cortisol, which is a major factor contributing to insulin resistance and has been associated with a higher risk of developing, and complications from, Type 2 diabetes.
   • Heart Rate Variability (HRV). Lower HRV indicates increased sympathetic nervous system (fight-or-flight) dominance, a state associated with high stress and counter-regulatory hormone release. Studies show a moderate negative correlation between real-time glucose levels and HRV: as glucose rises, HRV tends to fall, and vice versa. Use your smart device's HRV score to spot when your body is under stress before the glucose spike occurs.
2. The Sleep Deprivation Effect on Insulin Resistance: Even one night of restricted sleep (less than 7 hours) significantly affects metabolic function. Studies demonstrate that: 
   • Short sleep duration (e.g., less than 7 hours) is strongly and independently associated with an increased risk of Type 2 diabetes and poorer glycemic control (higher HbA1c and lower Time-in-Range) in people with diabetes.
   • Sleep deprivation impairs the ability of available insulin to regulate blood glucose levels—a hallmark of insulin resistance. This occurs partly due to hormonal shifts and an increase in pro-inflammatory markers.
   • Analyze your overnight and morning CGM data. Poor sleep quality is associated with higher average glucose levels and increased glycemic variability the following day. When your sleep is fragmented, check your CGM for nocturnal hypoglycemia (a common cause of sleep disruption) or simply the increased cortisol awakening response.

Actionable Strategies

1. Prioritize the 7–8 Hour Sweet Spot: Scientific consensus points to a nighttime sleep duration of 7 to 8 hours as having the lowest risk for metabolic dysfunction. Use your smart devices to enforce this consistent sleep schedule.
2. Proactive Stress Management: Since psychological stress is a relevant factor for the onset and progression of diabetes, implement stress-reduction techniques (like deep breathing or mindfulness) before an anticipated stressful event. Monitor your CGM afterward to see if this proactive approach helped blunt the subsequent glucose spike.
3. Analyze Your "Morning Rise": If your blood sugar consistently rises between 4:00 AM and 8:00 AM, assess your sleep data. If your sleep is poor, the rise might be exacerbated by elevated morning cortisol due to sleep debt, requiring a lifestyle intervention along with any insulin adjustment.

By actively monitoring sleep and stress, you are not just managing your sugar; you are managing the underlying physiological processes that govern it.

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